SOS! Is temporalis transplant my answer?

[bottsy42]

My AN surgery was 10/30/09, and I awoke to a drooped left side of my face. I improved quickly, yet now after 18 months, I still am unable to smile; only the right side moves.  Sure, my problem is mainly a sin of vanity, but I just know how much of a person a smile reveals. During an appt. with a well-reputed reconstructive plastic surgeon in Cincinnati, it was suggested that I might think about a left brow lift, left face lift with a temporal muscle transplant to the corner of my mouth.  My questions: 1.Has anyone had this exact type of operation? 2. How difficult was recovery? 3. Did your insurance cover any of it? 4. Most of all, did it allow teeth to show on the affected side to improve your smile? Could use any and all advice. Thanks. Peggy

[jilljpower]

Hi Peggy... I am in the same shoes as you are.  My surgery was in June of 2009 and I woke up with my nerve intact, yet complete paralysis on my AN side.  I still have minimal movement, yet my tone looks better meaning that I am not as droopy as I used to be.  I am seeing a facial reanimation therapist who analysis your face to see what may be moving.  Suprisingly, I had movement when I didn't know I did.  This way you can strengthen what is working which will help and will also give you hope.  I have been seeing Jackie Diels at the University of Wisconsin.

Are you going to the ANA Symposium.  There is going to be a Dr. Tessa Hadlock there who specializes in facial nerves out of the facial nerve center in Boston.  She has a website too just google her name.  I am planning seeing her speak at the syposium and then you get to choose a Dr. to meet with and I chose her.   She also wrote an article in the ANA Newsletter this month.  FYI!

Anyway, My advice would be to get a second or even third opinion.  There are a lot of different options and from what I have researched.  Unfortunately, I dont think there is one that can bring back a smile with teeth.  It's sad! I really wish this paralysis could be fixed.  I really feel your pain.  I am so tired of glances and stares.  Today I actually had to wave at a man who was staring at me in the market... He still didn't get it.   
If you ever need to vent, feel free to contact me..  I am there too.
Best of luck!  Jill
 

[bottsy42]

If you get this twice, Jill, I apologize b/c i thought I sent it before but didn't see it posted. Anyway, you made me laugh with your story about the man staring at you. We have to laugh or we will cry. I did receive the card about the symposium, which prompted me to register online with ANA. I think I will go and appreciate your info on the reanimation therapists. I'd like to know if I have any movement in this old face-and it truly is old-59! But I'm so darn vain in my old age. Thanks so much again.   It is truly comforting to have support from others who have experienced the same issues. Peggy

[Kaybo]

Hi Peggy!
I had the T3 in March of 2008 with Dr. Patrick Byrne of Johns-Hopkins.  I also had both of my brows lifted/evened out.  Insurance paid for everything except for the lift of the "good" side.  The basic recovery wasn't too bad - the first few days were pretty yucky (do you have feeling on that side?  I don't...) and I had a LOT of complications that made it worse.  They take tendon from your leg - that was really the worst to heal - I am always on the move!   ;)I was told that I would just have a "Mona Lisa" smile because you have to clench down to get movement, but at Thanksgiving of THIS year, I realized I was getting a bit of movement and do not have to bite down anymore.  This allows a bit of teeth to show that never did before but still smile closed mouth for pictures...Nancy is the one that told me about it - she has pics up here.  I'm sure she will be along soon!

I would be more than happy to chat with you about this more - if you'd like for me to call you, just PM me your number and a good time to call.

K   

[nancyann]

Hi Patty:  I had no recovery from facial paralysis, so I had the T3 (Temporalis Tendon Transfer) done 1 year & 5 months after the AN surgery.
Dr. Patrick Byrne @ Johns Hopkins did my & Kaybo's surgery.  You can check out his before/after pictures under 'facial reanimation.'
(I'm the 2nd photo).
Take @ least 4 more months to think about what you want to do.
Always good thoughts,  Nancy

[Suu]

Hi Peggy
Have you done any more research and come closer to a decision?
I'm about to have the 12/7 graft and if that doesn't work (God only knows that I'm praying for a miracle) I'll be back on this thread again to 'talk' abou the T3.
Best wishes
♥ ´)
.•´¸.•*´¨) ¸.•♥ ¨)
(,.•´ (.♥ •´ *Suu

[moe]

I had a different type of facial reanimation surgery called  gracilis flap for my permanent facial paralysis of 4 years. A portion of the inner thigh muscle (gracilis) was transplanted into my cheek with nerve innervation from the masseter nerve.  I can smile, and show a little teeth, but don't have that toothy grin. Let me know if you want any more specifics. Just another option.
Maureen

[nftwoed]

Moe;

  Just wondering if that type anastomosis is causing all your rain?
  Also; How is the thigh?  ; )
  You know I'm kidding a little, eh?
  I hope your days brighten up!

I had a different type of facial reanimation surgery called  gracilis flap for my permanent facial paralysis of 4 years. A portion of the inner thigh muscle (gracilis) was transplanted into my cheek with nerve innervation from the masseter nerve.  I can smile, and show a little teeth, but don't have that toothy grin. Let me know if you want any more specifics. Just another option.
Maureen

[moe]

Ha!
 Rain is good, but come on!
My thigh area, almost one year later is still a little numb and still twinges when I stretch the thigh. Wonder if it would have healed different, say if we were still in hot and humid S. TX (corpus christi).

The infected incision has left a LOVELY big scar, but who cares, I got my smile back! (or half smile )
Moe

[bottsy42]

I am thinking about it over time and still waiting to see if my insurance will cover any of it.  Are you happy with your result?  I've pretty much resigned myself to the fact that a "toothy grin" is not returning, but I'd give about anything for at least another tooth to show. Sheesh. So frustrating, but thank your for responding. I will check out yur doc's website. Thank you!
Peggy